Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Cancer Health Center

Font Size

Extragonadal Germ Cell Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Cellular Classification of Extragonadal Germ Cell Tumors

Extragonadal germ cell tumors can be benign (teratoma) or malignant. The latter group can be divided into seminoma and nonseminoma germ cell tumors, which include the following:

  • Embryonal carcinomas.
  • Malignant teratomas.
  • Endodermal sinus tumors.
  • Choriocarcinomas.
  • Mixed germ cell tumors.

Extragonadal germ cell tumors occur much more commonly in males than in females [1] and are usually seen in young adults. They are aggressive neoplasms and can arise virtually anywhere, but typically the site of origin is in the midline (mediastinum, retroperitoneum, or pineal gland). Gonadal origin should be excluded by careful testicular examination and ultrasound. The diagnosis can be difficult and should be considered in any patient with a poorly defined epithelial malignancy, particularly young individuals with midline masses.[2,3]

Recommended Related to Cancer

I Had the Cancer No One Talks About

By Darci Picoult It began with a bump. The size of a pinhead. Innocuous. An innocuous little pinhead of a bump on my vulva. Given that my gynecologist said the bump was probably nothing, I laughed it off. Which, in turn, made my bump mad. Very mad. It wanted my attention. And so it grew. I smeared it in medicine. It grew more. More medicine. More growth. Hanukkah came. Then Christmas. A war raged between us. I went to battle in the middle of the night with salt baths and creams. Prayed for its departure...

Read the I Had the Cancer No One Talks About article > >

An international germ cell tumor prognostic classification has been developed based on a retrospective analysis of 5,202 patients with metastatic nonseminomatous germ cell tumors and 660 patients with metastatic seminomatous germ cell tumors.[4] All patients received treatment with cisplatin-containing or carboplatin-containing therapy as their first chemotherapy course. The prognostic classification, shown below, was agreed on in early 1997 by all major clinical trial groups worldwide and should be used for the reporting of clinical trials' results of patients with extragonadal germ cell tumors.

Good Prognosis


  • Testis/retroperitoneal primary


  • No nonpulmonary visceral metastases


  • Good markers - all of:
    • AFP less than 1,000 ng/mL


    • hCG less than 5,000 iu/L (1,000 ng/mL)


    • LDH less than 1.5 x upper limit of normal

56% of nonseminomas

5-year progression-free survival (PFS) rate of 89%

5-year survival rate of 92%


  • Any primary site


  • No nonpulmonary visceral metastases


  • Normal AFP, any hCG, any LDH

90% of seminomas

5-year PFS rate of 82%

5-year survival rate of 86%

Intermediate Prognosis


  • Testis/retroperitoneal primary


  • No nonpulmonary visceral metastases


  • Intermediate markers - any of:
    • AFP 1,000 ng/mL or greater and 10,000 ng/mL or less


    • hCG 5,000 iu/L or greater and 50,000 iu/L or less


    • LDH 1.5 × N or greater and 10 × N or less
    Next Article:

    Today on WebMD

    Colorectal cancer cells
    New! I AM Not Cancer Facebook Group
    Lung cancer xray
    See it in pictures, plus read the facts.
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Ovarian cancer illustration
    Real Cancer Perspectives
    Jennifer Goodman Linn self-portrait
    what is your cancer risk
    colorectal cancer treatment advances
    breast cancer overview slideshow
    prostate cancer overview
    lung cancer overview slideshow
    ovarian cancer overview slideshow
    Actor Michael Douglas